Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 128577 | NC |
NPI | 1154384139 |
---|---|
Provider Name | Carrington Pertalion |
First Address | Boone, NC 28607-5009 |
Second Address | Boone, NC 28607-5009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 06/10/2020 |